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Breast Cancer TreatmentsDuctal carcinoma in situ (DCIS), regarded as the earliest form of cancer, is the presence of abnormal cells inside the lining of the breast milk duct. Reports suggest that approximately 25 percent of breast cancers diagnosed in the United States are DCIS and more than 60,000 women will be diagnosed in the US alone in 2015. DCIS is often called “non-invasive,” because it doesn’t spread beyond the milk duct to any normal surrounding breast tissue. While DCIS isn’t life-threatening, it does require treatment to prevent the condition from becoming invasive as the condition can potentially increase the risk of developing breast cancer later on. Most women with DCIS are effectively treated with breast-conserving surgery (lumpectomy), breast-removal surgery (mastectomy) and radiation therapy. Oncology specialists providing different treatments must report the same on their medical claims using the correct medical codes. In order to submit accurate medical claims, physicians should have essential medical billing and coding know-how and use the correct diagnosis and procedure codes to ensure correct and timely reimbursement. The ICD codes that are used to report this condition are:

ICD-9 Code

  • 233.0 Carcinoma in situ of breast

ICD-10 Code

  • D05.1 Intraductal carcinoma in situ of breast

Most women identified with this condition undergo a lumpectomy or a mastectomy to remove the abnormal cells. They may also receive radiation treatment. On the other hand, some may even take the extreme measure of removing one or both breasts completely.

A new study points out that many women are receiving unnecessary treatment for “stage 0” breast cancer as these treatments may make no serious difference in their outcomes. Patients with ductal carcinoma in situ (DCIS) have nearly the same likelihood of dying from breast cancer as women in the general population.

The study conducted by researchers at Toronto’s Women’s College Hospital and the University of Toronto and published in the Journal JAMA Oncology found that the vast majority of patients, about 97 percent are expected to be still alive even after 20 years of their early diagnosis.

As part of the study, the researchers used the Surveillance, Epidemiology and End Results (SEER) 18 registries database to study women diagnosed with DCIS from the year 1988-2011. More than 100,000 women were studied and their risk of dying from breast cancer was compared with that of women in the general population. Women were aged 54 years on average at the time of diagnosis and the average duration of follow-up was 7.5 years. The key findings of the study include:

  • It was found that breast cancer-specific death rate after DCIS diagnosis was at 1.1 percent and the rate over 20 years was at 3.3 percent.
  • When compared with women in the general population, the risk of dying from breast cancer was 1.8 times higher for women who had a DCIS diagnosis.
  • It was found that the risk of death was much higher for some subset of women. The death rate was higher for those women who received a diagnosis before age 35 years when compared against older women (7.8 percent vs. 3.2 percent). On the other hand, the death rate was higher for black women when compared with non-Hispanic white women (7 percent vs. 3 percent).

The findings of the study signify the fact that many women are undergoing unnecessary treatments for pre-malignant conditions that are unlikely to develop into life-threatening cancers. Therefore, cancer researchers need to do a better job in figuring out who is at higher risk of dying after DCIS diagnosis, and in finding effective treatment approaches that may reduce deaths.